How Is Pancreatic Cancer Diagnosed
Its difficult to detect pancreatic cancer in the early stages. This is because healthcare providers cannot feel the pancreas in a routine exam. If your provider suspects that you may have pancreatic cancer, they may order imaging tests to take pictures of the internal organs. An endoscopic ultrasound can also be done.
An endoscopic ultrasound is a thin tube with a camera at the tip that is passed through the mouth and into the stomach. The ultrasound probe at the end of the endoscope allows imaging of the pancreas through the stomach wall. If necessary, an ultrasound-guided biopsy from the pancreas can be obtained during the procedure.
A blood test can find a substance called a tumor marker. For pancreatic cancer, high levels of carbohydrate antigen 19-9 a type of protein released by pancreatic cancer cells might indicate a tumor.
Everyone who is newly diagnosed with pancreatic cancer should talk to their doctor about doing genetic counseling and testing to see if there is a hereditary reason they developed pancreatic cancer. This is based on recommendations from two of the largest cancer organizations, the National Comprehensive Cancer Network and the American Society of Clinical Oncology .
What To Know About Pancreatic Cancer
Pancreatic cancer begins in the tissues of your pancreas an organ in your abdomen that lies horizontally behind the lower part of your stomach. Your pancreas releases enzymes that aid digestion and hormones that help manage your blood sugar.
Pancreatic cancer typically spreads rapidly to nearby organs. It is seldom detected in its early stages. But for people with pancreatic cysts or a family history of pancreatic cancer, some screening steps might help detect a problem early. One sign of pancreatic cancer is diabetes, especially when it occurs with weight loss, jaundice or pain in the upper abdomen that spreads to the back.
Treatment may include surgery, chemotherapy, radiation therapy or a combination of these.
How Is Pancreatic Cancer Treated
Pancreatic cancer treatment depends on certain things, including where the tumor is located, what stage it is in, how healthy you are and whether or not the cancer has spread beyond the pancreas. Treatment options include:
- Surgical removal: The cancerous part of the pancreas is removed. Lymph nodes near to the pancreas may also be removed. The surgery to remove the pancreas or part of the pancreas is called a pancreatectomy. If your tumor is located in the head of the pancreas, your provider may recommend the Whipple procedure. This surgical method removes the head of the pancreas, the duodenum , the gallbladder, a portion of the bile duct and nearby lymph nodes.
- Radiation therapy: High-speed energy used to kill the cancer cells.
- Chemotherapy: This method uses drugs that kill cancer cells.
- Immunotherapy: Treatment to help your body fight the cancer. Immunotherapy has largely been ineffective against pancreatic cancer, but about 1% of people with pancreatic cancer and a specific genetic change may benefit from it.
- Targeted therapy: Directed at certain genes or proteins that help cancer grow. Genetic testing is generally how we determine if a targeted therapy is right for you.
- Clinical trials: Talk to your healthcare provider about whether participating in a clinical trial might be an option.
Other things to know about treatment:
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Pancreatic Cancer Can Be Asymptomatic For A Long Time
Pancreatic cancer can go undetected for a long period of time because of where the organ is located. “The pancreas is deep inside the body, so early tumors can’t be seen or felt by health care providers during routine physical exams,” the American Cancer Society explains. “People usually have no symptoms until the cancer has become very large or has already spread to other organs.”
When warning signs do arise, the symptoms depend on where the cancer is in the pancreas. “You can have a relatively small tumor in the very end of the pancreas, near the opening to the duodenum, that can cause jaundice,” Matthew Walsh, MD, told a Cleveland Clinic podcast.
As a tumor grows from the pancreas and invades certain nerves and organs, this can cause mid-back pain. “Some people also report that they feel pain in their shoulder or under their shoulder blade,” warns Pancreatic Cancer Action. “Other people feel pain in their back and abdomen at the same time.”
Pancreatic Cancer Is Often Deadly But A New Approach Is Raising Hope
Bill Bastian was caught completely off-guard when a doctor told him that he had pancreatic cancer and would only have 15 months to live. It was August 2015 and Bastian had thought the pain in his belly was due to something he ate.
One of the things I thought was, you got the wrong guy, said Bastian, 69, of Eden Prairie, Minnesota.
His cancer was stage 3, meaning it had not spread from his pancreas to other organs, but had grown into a critical artery just outside his pancreas. That made it inoperable, according to his doctor at the time.
Thats when Bastian decided to seek another opinion at the Mayo Clinic in Rochester, Minnesota. There, he received a totally different prognosis: surgery and longer survival were possible.
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What Is The Pancreas
The pancreas is a small, hockey stick-shaped gland located behind the stomach. The main jobs of the pancreas are to aid in food digestion and regulate blood sugar levels in the body. The pancreas is involved in maintaining blood sugar levels because it makes insulin and glucagon, two hormones that control blood sugar levels.
Mayo Clinic Q And A: Pancreatic Cancer Risk Symptoms And Treatment
DEAR MAYO CLINIC: My mother recently was diagnosed with diabetes, but due to abdominal pain and other issues, her doctor suspects she might have pancreatic cancer. How is pancreatic cancer diagnosed and what are the symptoms to watch for?
ANSWER: I am so sorry to hear about your mothers recent issues. It can be a scary time for everyone when there is uncertainty related to a cancer diagnosis, let alone general health issues.
Although it is not a common form of cancer, pancreatic cancer is a very serious disease and is considered one of the least survivable cancers. This is because it spreads, or metastasizes, quickly before symptoms appear often resulting in late detection. Approximately 60,000 people are diagnosed with pancreatic cancer annually in the U.S., with the average age of diagnosis at 70. However, the incidence of diagnosis in younger people is steadily increasing.
As with many other cancers, only a small fraction of pancreatic cancer cases have specific, known heritable genetic causes, but there is an increased risk if other immediate family members have been affected. For most people diagnosed with pancreatic cancer, there is no obvious predilection, but there are some known risk factors. Smoking is one of the most common to be strongly associated with pancreatic cancer risk.
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Treatments To Help You Cope With Distress
People with cancer frequently experience distress. Some research suggests distress is more common in people with pancreatic cancer than it is in people with other types of cancer.
If you’re distressed, you may have difficulty sleeping and find yourself constantly thinking about your cancer. You may feel angry or sad.
Discuss your feelings with your doctor. Specialists can help you sort through your feelings and help you devise strategies for coping. In some cases, medications may help.
Integrative medicine and alternative therapies may also help you cope with distress. Examples include:
Talk with your doctor if you’re interested in these treatment options.
How To Reduce The Risk
Joseph explains, “About nine out of 10 cancers are non-hereditarymeaning we have to look at what is happening in terms of the food we eat , the sad reality that we’ve become a sedentary society and are moving our bodies less, we are eating more processed food, we have the highest obesity rate in the industrialized world , our medical system ranks very poorly compared to other industrialized countries , we consume about 25 percent of the world’s prescription pharmaceutical drugs but our population is a small fraction of the world’s population. I could go on.
If I had to name a couple of key things I would say cut down on processed sugar. The amount we put in our bodies today as compared to say, 150 years ago, is astounding. Second, become aware of what you put on, in, and around your body and home at all times. Becoming healthy/staying healthy is hard work. But getting/dealing with cancer is infinitely more difficult.”
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Preparing For An Appointment
Start by making an appointment with your doctor if you have any signs or symptoms that worry you. He or she may recommend tests and procedures to investigate your signs and symptoms. If your doctor suspects you have pancreatic cancer, he or she might refer you to:
- A doctor who diagnoses and treats digestive conditions
- A doctor who treats cancer
- A doctor who uses radiation to treat cancer
- A surgeon who specializes in operations involving the pancreas
What Questions Should I Ask My Healthcare Provider
Develop an open and cooperative relationship with your healthcare provider. Take a list of questions with you so you remember to get the answers you need to live your best life. These questions might include:
- What stage is the cancer? What does this mean for me?
- What are my treatment options? Which do you recommend and why?
- What side effects might I develop as a result of treatment?
- Is genetic testing right for me?
- Am I able to be a part of a clinical trial?
- Will I be able to keep working and doing the things that I need or want to do every day?
- Are there situations in which I need to call you immediately or get emergency care?
- Can you tell me where to find financial support?
- Can you tell me where to find emotional support?
- What should I do to stay as healthy as I can?
Make sure to follow the plan that you and your provider agree on. Keep to the schedule of follow-up appointments and testing.
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A Willingness To Tackle The Challenge
Already into his first round of chemotherapy upon arriving at Mayo, John says the first question Dr. Truty asked him was if he was ready for more. “I said, ‘Yes I am,'” John says. “My care team described as weed killer and said there’d be no surgery until I went through more chemo and radiation to try and shrink the tumor as much as possible.”
After eight rounds of chemotherapy, 25 rounds of radiation and another 25 rounds of oral chemo, Dr. Truty reassessed John’s condition. “He made it clear my ability to have surgery was predicated on what they saw on my presurgery PET scan â whether my treatments had done what they were designed to do,” John says. “After my scan, he looked at the results and said, ‘Are you ready to go into surgery?'”
Johnwas, and early the next morning, he did. While Dr. Truty understands why othersurgeons had advised against surgery due to the location of John’s tumor, hesays it was something he and his surgical team were prepared for.
“We just have a different perspective on things here at Mayo Clinic, and we’re willing to take on the more challenging cases that don’t necessarily fit into nice, normal boxes.”
Mark Truty, M.D.
What Is The Life Expectancy Of Someone With Pancreatic Cancer
Pancreatic cancer is usually not found until it has become advanced. Therefore, it is one of the leading causes of cancer deaths. After one year, the pancreatic cancer survival rate is about 20%. After five years, that number drops to about 6%. Every year, about 3,000 more people die of pancreatic cancer than die of breast cancer in the United States.
If surgery can be performed and you have a section of your pancreas removed, the average survival rate is 18 to 20 months. The five-year survival rate in such cases rises to 10 to 25%.
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Sharing Mayo Clinic: A Pancreatic Cancer Story With A Happy Ending
When doctors discovered a stage 3 tumor on John Magee’s pancreas that they deemed inoperable, John took his health into his own hands by seeking a second opinion at Mayo Clinic. That decision made all the difference. Today, John is cancer-free.
Lookingback, the signs were there. “I can see I was sick,” John Magee says. “Eventhough I might not have felt it, looking back at old pictures, I looked it.”
Thoseresponses were a result of weeks of unexplained pain in John’s lower back thathad left him physically and emotionally worn down. After John admitted he wasin pain, his primary care physician set about determining its cause. “Westarted doing tests to try to figure out what was going on,” John says. “Initially,we thought I’d herniated a disk in my back again because I’d done that before.”
Test results showed the problem wasn’t in his back, and the true source of the pain remained a mystery. After weeks of being unable to pinpoint a cause or a solution, John began doing his own research. “One night, I read that the pain pattern I was experiencing is common with pancreatitis and pancreatic cancer,” he says. “So I talked to my doctor about it.”
What Is Pancreatic Cancer
The pancreas is a relatively small, but very important organ in the abdomen. It is only about 6 inches long and about 3 inches wide and relatively flat. It looks a bit like an island that has a narrow head and wide base. The organ lies behind the stomach and in front of the spine and has two major functions, both essential to health. The first is the exocrine cells, which excrete fluids that are essential for digestion in the small intestine. The endocrine cells of the pancreas make hormones, the most widely known being insulin that regulates blood sugar and whose production is required to avoid diabetes. Cancer can form in these cells and mainly in the exocrine cells. Like cancer everywhere in the body, the growth of cancer cells is not regulated and if not removed or killed will metastasize around the body and ultimately lead to death. The spread of the disease is characterized by various stages . Stage 0 is carcinoma in situ and localized to one place in the pancreas whereas Stage IV is a wide spread of the disease to remote organs. Stages I through III are graded spread of the disease from local to body wide.
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Newsimproved Detection And Treatment Of Pancreatic Cancer Provides Hope
Historically, doctors have given pancreatic cancer patients chemotherapy or radiation hoping it would cause the tumor to shrink or pull away from the artery or vein its ensnared. Truty believes thats the wrong approach. Youre going to be sorely disappointed if thats what youre expecting, Truty told NBC News.
The Mayo Clinic approach works like this: Patients are given extended, personalized chemotherapy until levels of a tumor marker in the blood called CA 19-9 fall to a normal range. Then if a PET scan shows the tumor is destroyed, doctors move forward with radiation and surgery.
Among 194 pancreatic cancer treated this way at the Mayo Clinic, 89 percent lived longer than the expected 12 to 18 months. The approach has pushed average survival to five years after diagnosis, according to a study by the Mayo Clinic.
And for about a third of patients in the study, Truty said his team couldnt even calculate their average survival because theyre alive and doing very well.
Outside pancreatic cancer experts say the Mayo approach is exciting. Its really remarkable to be able to accomplish this, said Allison Rosenzweig, senior manager of Scientific and Clinical Communications at the Pancreatic Cancer Action Network.
But Rosenzweig cautions the approach wont work for all patients diagnosed with stage 3 pancreatic cancer. Some wont respond to the chemotherapy necessary to kill tumor cells. Others are too sick to tolerate the therapy.
Why Choose Md Anderson For Pancreatic Cancer Treatment
About 80% of pancreatic cancers are diagnosed after the disease has reached an advanced stage, which makes them hard to treat. Less than 20% of pancreatic cancers are caught when the cancer is still confined to the pancreas or closely surrounding areas. Though the disease has not spread, these cases are treated with complicated surgical operations that require a high level of experience to perform safely and effectively.
Whether youre diagnosed with localized or metastatic pancreatic cancer, its important to find a team of physicians with the most innovative treatment options and expertise. At MD Anderson, you are the focus of a personalized pancreatic cancer treatment plan that brings together a multidisciplinary team of some of the top pancreatic cancer professionals that use the most advanced techniques.
World-class surgeons treating localized pancreatic cancer
When pancreatic cancer is confined to the pancreas, and sometimes when it has spread only to the nearby areas, it can be removed with surgery. The highest chances for successful treatment occur when the tumor is completely removed, and the surgical techniques required are extremely complex. Because our surgeons are among the most experienced and skilled in the nation, MD Anderson has:
Pioneers of pancreatic cancer treatment
Our experts provide comprehensive pancreatic cancer care, and they have pioneered several advances in the field, including:
Developing more effective treatment options through clinical trials
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Upper Or Middle Belly/back Pain
Abdominal pain is a common symptom of pancreatic cancer, as tumors that have grown fairly large start pressing on adjacent organs, causing discomfort and pain.
Its also common for these cancers to cause pain in the patients back, usually as a result of spreading to nerves surrounding the pancreas.
However, back and belly pain may also indicate other conditions besides pancreatic cancer, so its important to speak with your doctor if youre experiencing pain.
